Disabled Veteran’s Tax Exemption

1 This form is prescribed by the Director, Division of Taxation, as required by law, and may not be altered without the approval of the Director. Form: Rev: Feb. 2018 Form pg 1 of 2 CLAIM FOR PROPERTY TAX Exemption ON DWELLING HOUSE OF Disabled VETERAN OR SURVIVING SPOUSE/CIVIL UNION OR DOMESTIC PARTNER OF Disabled VETERAN OR SERVICEPERSON ( 54:4-3 .30 et seq.; 18 et seq.) IMPORTANT: File this completed clai m with your municipal tax assessor. (See Guidelines) 1. CLAIMANT NAME _____ Name(s) of veteran claimant owner (& spouse, as tenants by entirety, or civil un ion or domesti c partner) or of surviving spouse/civil union or domestic partner permanently residi ng in dwelling. 2. DWELLING LOCATION _____ Street A ddress of claimant owner's pr incipal reside nce Phon e # Email _____ County Municipa lity _____ Block Lot Qualifier 3.

2 Disabled VETERAN/SURVIVING SPOUSE/CIVIL UNION OR DOMESTIC PARTNER OF Disabled VET OR SERVICEPERSON (Check A, B, or C) A. Hon orabl y discharged di sabled veteran with active wartime service in United States Armed Forces. ATTACH copy DD214. B. Surviving spouse/civil un ion or domesti c partner of honorabl y discharged Disabled veteran with active wartime service in United States Armed Forces; and I have not remarried/formed a new registered civil union or domesti c partnership. ATTACH copy DD214. C. Surviving spouse/civil un ion or domesti c partner of serviceperson who di ed on wartime active du ty in the United States Armed Forces; and I have not remarried/for med a new regist ered civil un ion or domestic partnership. ATTACH copy Military Notification of Death.

3 4. ACTIVE WAR TIME SERVICE PERIOD (Check All Applicabl e Service Periods) NOTE New Jersey amended wartime service criteria for the 100% Disabled Veteran s Property Tax Exemption effective January 16, 2018. Wartime service in a specified geographic location for a minimum number of days is no longer required. If the veteran was on active duty during any of the statutory service periods listed above, he or she meets the wartime service criterion for Exemption . Other requirements, such as honorable discharge, property ownership, disability, etc., are unchanged. This amendment does not apply to the $250 Veteran s Property Tax Deduction. (*Refer to the guidelines for additional information.) A. World Trade Center Rescue & Recovery September 11, 2001 May 30, 2002 B.

4 Operation Northern/Southern Watch August 27, 1992 March 17, 2003 C. Operation Iraqi Freedom March 19, 2003 Ongoing D. Operation Enduring Freedom September 11, 2001 Ongoing E. "Joint Endeavor/Joint Guard" Bosnia & Herzegovina November 20, 1995 June 20, 1998 F. "Restore Hope" Mission Somalia December 5, 1992 March 31, 1994 G. Operation Desert Shield/Desert Storm Mission August 2, 1990 February 28, 1991 H. Panama Peacekeeping Mission December 20, 1989 January 31, 1990 I. Grenada Peacekeeping Mission October 23, 1983 November 21, 1983 J. Lebanon Peacekeeping Mission September 26, 1982 December 1, 1987 K. Vietnam Conflict December 31, 1960 May 7, 1975 L. Lebanon Crisis of 1958 July 1, 1958 November 1, 1958 M. Korean Conflict June 23, 1950 January 31, 1955 N.

5 World War II September 16, 1940 December 31, 1946 This form is prescribed by the Director, Division of Taxation, as required by law, and may not be altered without the approval of the Director. Form: Rev: Feb. 2018 Form pg 2 of 2 5. DISABILITY (Check A or B & compl ete C ) A. Wartime service-connected di sability from paraplegia, sarcoidosis, osteoc hon dr itis resulting in pe rmanent los s of us e of both legs, or permanent paralysis of both l egs a nd lower parts of the body, or from hemipl egia and having pe rmanent paralysis of on e leg and on e arm or either side of the body, resulting from injury to spi nal cor d, skeletal structure, or brain or from disease of spi nal cord not resulting from any form of syphilis; or from tot al bl indn ess; or from ampu tation of both arms or both legs, or both hands or both feet, or the combi nation of a hand and a foot; or B.

6 Other wartime service-connected disability declared to be a total or 100% permanent disability, and not so evaluated solely because of hospitalization or surgery and recuperation, sustained through enemy action , or accide nt, or resulti ng from disease contracted while in such service. C. Date de termined 100% permanently and totally disabl ed _____. 6. OWNERSHIP & OCCUPANCY (Compl ete A, B, and C) A. I (my spouse/civil un ion partner & I, as tenants by entirety), solely own or hold legal title to the above dwelling house. P artial owners: I (as joint tenant/tenant in common) o wn _____%. Grantee ( buyer) _____ name per deed. Deed Date _____. B. The dwelling hou se is One-Family and I occupy all of it as my pr incipal reside nce.

7 OR C. The dwelling hou se i s Multi -Unit a nd I occupy % as my pr incipal reside nce. 7. CITIZEN & RESIDENT (Compl ete A or B) A. As of _____(insert da te - m onth/da y/year), I, the above named veteran claimant was a citizen and legal or domiciliary reside nt of New Jersey. B. As of _____(insert date - month/da y/year), I, the above named surviving spouse/civil union or domesti c partner claimant was a citizen and legal or domicili ary reside nt of New Jersey; and My deceased veteran or serviceperson spouse/civil union or domesti c partner was a citizen and reside nt of New Jersey at death. I certify the above declarations are true to the be st of my knowledg e and be lief and understand they will be considered as if made un der oa th and subject to pe nalties for perjury if falsified.

8 Signature o f claimant Date USE ONLY Block _____ Lot _____ Qualifier _____ Approved Disallowed Assessor_____ Date _____ This form is prescribed by the Director, Division of Taxation, as required by law, and may not be altered without the approval of the Director. Form: Rev: Feb. 2018 Guidelines pg 1 of 2 GENERAL GUIDELINES APPLICATION FILING PERIOD File thi s form with the municipal tax assessor at any time during the tax year. Partial or prorated exempt ion is pe rmitted for the remainder of any taxable year from the da te ownership or title to the dwelling house is acquired provided all ot her eligibi lity requirements are met. For exa mpl e, where application is filed on June 1s t of the tax year for exempt ion on a dwelling house acquired on February 14th of the tax year, the assessed value is to be prorated for taxation pu rposes so tha t 44 /365th' s of the total assessment would be taxabl e and 321/36 5t h' s would be exempt.

9 ELIGIBILITY REQUIREMENTS A. Disabled Veteran C laimant (must meet a ll 5 requirements) 1. have had active war t ime service in Uni ted States Armed Forces and been honorably di scharged; 2. have a Uni ted States Veterans Admini stration certification of w artime service-connected disability as described under #5 on front o f t his DVSSE C laim; 3. wholly or p artia lly own or hold legal title to the dwelling house for w hi ch exempt ion is claimed; 4. occupy the dwelling house as the princ ipa l residence; 5. be a citizen and legal or d omiciliary resident o f N ew Jersey. B. Surviving Spouse/Civil U nion or Domestic Partner Claimant (must meet a ll 6 requirements) 1. document that the deceased veteran or serviceperson was a citizen and resident of New Jersey at death who had active wartime service in the Uni ted States Armed Forces and who was honorably discharged or who died on active wartime duty; 2.

10 Document t hat the deceased veteran had V. A. c ertified wartime service-connected di sability; 3. not have remarried/formed a new r egistered civil union or domestic partnership; 4. wholly or p artia lly own or hold legal title to the claimed dwelling house; 5. occupy the dwelling house as the princ ipa l residence; 6. be a citizen and legal or d omiciliary resident o f N ew Jersey. **NOTE - C laimants must inform the assessor of any change in status which may affect the ir con tinu ed entitlement to the Exemption . DWELLING HOUSE & CURTILAGE DEFINED Dwelling house means any one-family building or structure or un it in a horizontal property regime or condomini um or multiple-family building or structur e on that portion occupied by the claimant as hi s legal residence inc luding any outhouses or appurtenances used for the dwelling's fair enjoy ment.